Nursing Competency Paper

I am Amanda Selich, 27 years old, and have been living in San Francisco for roughly 10 years. I grew up in the East Bay with my 3 siblings and was raised by a single father. Much of my childhood was spent taking care of my younger siblings. This responsibility was so demanding I was forced to drop out of high school and become their “surrogate mother”. However at the age of 24 I was able to get my GED and finally attend college. In fact this past May I graduated from City College of San Francisco with highest honors in Science and Math.

Patient-centered care refers to the view that patients and their family members are partners in developing a care plan. This stems from the belief that the patient is in control and that the care provided is rooted in respect that addresses the patient’s personal needs and values (Barnsteiner & Sherwood, 2012). Creating a partnership with a patient that allows them to grasp the goals and methods of their plan of care and includes them in the decision-making process can prevent errors from occurring. This gives the patient the opportunity to correct any

The Institute of Medicine (IOM) has recognized five key core competencies (CCs) that all healthcare professionals should be aware of during practice. The initial competency described concentrates on patient-centered care. Throughout history, the nursing community has continued to evolve, both in the practicing aspect and in level of caring for patients. During this evolution of nursing care, nurses providing hands on care to patients must refer to the Institute of Medicine, peer reviews and/or evidenced-based research to guide them properly as it applies to the core concepts of nursing. The first core competency according to the IOM is patient-centered care.

After reading the Nurse of he Future Nursing Core Competencies (NOF), I believed it was created to help nurses used critical thinking when delivering care. Being a nurse had empowered me to know the important of critical thinking when caring for patients. “Nurses use critical thinking to integrate objective data with knowledge gained from an assessment of the subjective experiences of patients and groups, and to apply the best available evidence and research data to the processes of diagnosis and treatment”.

The role of nurse practitioner is valuable when discussing collaborative care. There are so many levels of care, so many health entities, and so many insurer criteria involved that it is instrumental to have a role that can work towards help bring all aspects together. In addition to diagnosing, treating, and managing care, the role of the nurse practitioner is to manage simple and episodic acute health issues along with chronic disease (Sangster-Gormley, Martin-Misener, & Burge, 2013). It is important to note that although this is a function of this role, nurse practitioners also practice from a holistic point of view which allows them to help manage patient conditions or wellness in a more complete fashion. This includes helping patients have access to care beyond primary and secondary care settings. This encourages nurse practitioners to work alongside other health care and allied health professions, and families to create an individualized plan for every patient (van

With the implementation of two milestone in the healthcare system, the Affordable Care Act (ACA) and Health care education and reconciliation act of 2010. The ACA assist in easy access to high-quality and cost-effective and also assist in the shift of the nation’s health care system in the direction of primary and preventive care. Also the health care education and reconciliation act is an initiative to motivate nurses and provide grants and scholarships to acquire higher education and take active part in the reformed health care system. In order to create the health care system which focus on primary and preventive care, the role of nurses is very vital and important especially the advanced practice registered nurses (APRN) (Implementing Health Care Reform: Issues for Nursing, 2010). American Nurses Association always advocate and nurture nurses including APRNs and Patient Protection and Affordable Care Act (PPACA) also acknowledged and recognized the role of APRNs in the provision of primary and preventive care. This acknowledgement of PPACA open the new horizon for the APRNs in the transformed patient-centered care system (Haney, 2010). In this presentation, the writer will discuss new emerging care delivery model which are mentioned in the PPACA. These delivery model involve interdisciplinary and care management services of RNs (The National Academies Press, 2011).

Like most other professions, nursing is controlled by government regulatory agencies and professional organizations. For instance, boards of nursing in various states are the government entities mandated to regulate nursing at the state level, while the American Nurses Association is a professional organization that governs nursing at the nation level. Regulatory agencies and professional organizations are guided by the principle of common but differentiated responsibilities.

The patient centered medical home was developed to improve the quality of care provided within the health care system. This ideal focuses around exactly as it sounds, the patient. The primary goals of the patient centered medical home model is to enhance primary care through means of better access, coordination of care, prevention, quality, and safety (Smith, 2013). There are various methods used, but the most recognized is multiple care specialties operating under one physician. Many various medical professionals and services form the patient care team within this system. The team is led by the patient’s primary care physician. The physician and care team will

Patient-centered care encompasses ideas, skills, and attitudes that promote greater patient empowerment, responsibility, and prioritizing patients’ needs and experience of healthcare in influencing how care is delivered (Lorig, 2012). Patient-centered care focuses on individualizing care to meet the health care needs of individual patients but also encourages patient’s to be active participants in their own care. Important aspects of patient-centered care that focuses on the patient’s experience include cultural competency, involvement, and continuity of care.

The national league for nurses defines critical thinking in the nursing process as “a discipline specific, reflective reasoning process that guides a nurse in generating, implementing, and evaluating approaches for dealing with client care and professional concerns” (Kozier, 2008). This definition is imperative to help a nursing student learn how to think in terms of nursing care. Nursing students must achieve a comprehensive understanding of critical thinking in order to understand the nursing process. The purpose for this paper is for nursing students to learn how to use the nursing process, how to properly document their findings and assessments, and correctly implement APA formatting in a formal paper.

There are five core competencies needed for health care professionals and they are provide patient centered care, work in interdisciplinary teams, employ evidence based practice, apply quality improvement, and utilizing informatics. In this paper, I will go into further detail how providing patient centered care is challenging, how to overcome the challenges, how it relates to my chosen profession, and how this competency can impact delivery of care to patients.

The health care is reforming in a way that care delivery models have been formed and people will be paying for quality of care as a whole (Fairman, Rowe, Hassmiller, & Shalala, 2011). The health care reform law is attempting to balance the system of health care resources in that a balance will be yielded to award care value over the volume of care provided. This reform calls into nurse leadership and the input of nurses who contribute the largest labor to the health care system. Registered nurses are vital in the delivery model of patient centered care system.

Advance practice nurses (APNs) are at the forefront of today’s healthcare system. To keep up with the aging population and the demands of complex healthcare needs of this society, APNs need to perform at the highest quality to provide efficient, effective, holistic and improve patient outcome and satisfaction while reducing cost. To provide such care, APNs need to implement the six core competencies as outlined by Hamric. These six core competencies are: direct clinical practice, expert coaching and advice, consultation, research skills, clinical and professional leadership, collaboration, and ethical decision-making. This paper will explore how APNs can implement each of the six core competencies to support the effective improvement of outcomes such as patient satisfaction, readmissions, cost, health status, and complications. In addition, each of the six core competencies of the APN’s role identified by Hamric will be outlined and applied using a fictitious patient case study.

Nevertheless, many organizations continue to struggle with what “it” is. This ambiguity ultimately leaves many with vague or muddled expectations for what constitutes patient-centered care. Is it a surprise, then, that many leaders report feeling bewildered at how to go about becoming more patient-centered? Or that others, convinced that their approach is indeed a patient-centered one, are surprised to find data reflecting patient and/or staff discontent? In the broadest terms, patient-centered care is care organized around the patient. It is a model in which providers partner with patients and families to identify and satisfy the full range of patient needs and preferences. Not to be overlooked in defining patient-centered care is its concurrent focus on staff. To succeed, a patient-centered approach must also address the staff experience, as staff’s ability and inclination to effectively care for patients is unquestionably compromised if they do not feel cared for themselves. Although patients may not always be able to accurately assess the clinical quality of their care, or whether safety processes are in place, patient safety and high clinical quality are fundamental to a patient-centered approach. Patient-centered care does not replace excellent medicine―it both complements clinical excellence and contributes to it through effective partnerships and communication. A wealth of resources exists to guide organizations in addressing clinical

Nursing involves greater purpose beside the objective of treating patients’ ailments in an efficient and effective manner. Nurses, physicians, and health care providers across the board uphold the duty to treat patients with the utmost value of care. As a universal definition of care does not exist, Anita Finkelman and Carole Kenner explain care is drawn from four perspectives: a sense of care involving compassion, knowledge and expertise that allows nurses to advocate for the patient in addition to treating the medial complication, and “…competence in carrying out all the required procedures, personal and technical, with true concern for providing the proper care at the proper time in the proper way (Finkelman & Kenner, 2013) . Combining the foundation of every perspective leads to the Institute of Medicine’s (IOM) first core competency of patient-centered care. Sans the image of patient-centered care the practice of nursing and medicine alike will lack the passion the American Nursing Association envisions for “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and care of individuals, families, communities, and populations” (Finkelman & Kenner, 2013). Therefore, the author of this paper explores the IOM’s definition of patient-centered care, implementation of the concept, and its pivotal relationship to the nursing profession.